scholarly journals Effects of Vegan and Ketogenic Diet Plans on Hemoglobin A1c Levels in Type 2 Diabetes

2020 ◽  
Vol 3 ◽  
Author(s):  
Kimberly Jones ◽  
Erin Jefferson ◽  
Brian Henriksen
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Ketogenic Diet ◽  
Hemoglobin A1c ◽  
The United States ◽  
Vegan Diet ◽  
Medication Therapy ◽  
Ketogenic Diets ◽  
Significant Difference

Background/Objective: Type 2 diabetes affects 8.5% of adults over the age of 18 and costs the United States an average of 327 billion dollars per year. Two diets, the ketogenic diet and the vegan diet have both been shown to promote weight loss as well as reduce A1c’s in individuals with type 2 diabetes. Ketogenic diets are best defined as high fat, low carbohydrate diets that induce a state of nutritional ketosis. Vegan diets are centered around the consumption of legumes, fruits, vegetables, and whole grains. All animal-derived products including gelatin are avoided. The primary goal of this study is to determine whether the vegan diet is non-inferior to the ketogenic diet in the reduction of hemoglobin A1c levels in adults with type 2 diabetes.     Methods: A total of 120 participants between the ages of 18 and 70 who have an A1c between 6.5 and 10.0 will randomly be assigned to either the vegan or ketogenic diet groups. Dietary interventions will be implemented for a total of 24 weeks. Hemoglobin A1c levels will be measured at weeks 0, 12, and 24 and values will be compared using the repeated-measures analysis of variance test to determine if there is a significant difference between groups.   Expected results: It is expected that both groups will experience a decrease in their hemoglobin A1c levels, but that a more significant reduction will occur in those following the vegan diet. Weight loss is also an anticipated side effect in both groups.  Conclusion/Potential impact: This study has the potential to provide individuals with a more cost-effective management strategy to medication therapy in type 2 diabetes. Choosing to adopt healthier dietary practices will ultimately lead to better blood glucose control and a lower likelihood of developing diabetic complications.  

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

scholarly journals Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2005 ◽  
Author(s):  
Yeo Jin Choi ◽  
Sang-Min Jeon ◽  
Sooyoung Shin
Keyword(s):  
Type 2 Diabetes ◽  
Ketogenic Diet ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Ketogenic Diets ◽  
Fat Diets ◽  
Overweight Or Obesity

The aim of this meta-analysis was to explore the efficacy of a ketogenic diet in metabolic control in patients with overweight or obesity and with or without type 2 diabetes. Embase, PubMed, and Cochrane Library were searched for randomized controlled trials that enrolled patients with overweight or obesity on a ketogenic diet for metabolic control. Fourteen studies were included in meta-analysis. The effects of ketogenic diets on glycemic control were greater for diabetic patients relative to those of low-fat diets, indicated by lower glycated hemoglobin (SMD, −0.62; p < 0.001) and homeostatic model assessment index (SMD, −0.29; p = 0.02), while comparable effects were observed for nondiabetic patients. Ketogenic diets led to substantial weight reduction (SMD, −0.46; p = 0.04) irrespective of patients’ diabetes status at baseline and improved lipid profiles in terms of lower triglyceride (SMD, −0.45; p = 0.01) and greater high-density lipoprotein (SMD, 0.31; p = 0.005) for diabetic patients. Other risk markers showed no substantial between-group difference post intervention. Our study findings confirmed that ketogenic diets were more effective in improving metabolic parameters associated with glycemic, weight, and lipid controls in patients with overweight or obesity, especially those with preexisting diabetes, as compared to low-fat diets. This effect may contribute to improvements in metabolic dysfunction-related morbidity and mortality in these patient populations.

scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

Effect of a group medical clinic for veterans with diabetes on body mass index

2018 ◽  
Vol 15 (3) ◽  
pp. 187-196
Author(s):  
Adva Eisenberg ◽  
Matthew J Crowley ◽  
Cynthia Coffman ◽  
David Edelman
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Body Mass ◽  
Hemoglobin A1c ◽  
Medical Clinic ◽  
Significant Difference ◽  
The Impact

Objective To assess the impact of a group medical clinic designed for patient with type 2 diabetes mellitus and hypertension on body mass index. Methods Using data from a randomized trial of 239 veterans with type 2 diabetes mellitus, we performed a secondary analysis using analysis of covariance mixed models to explore the effect of a 12-month group medical clinic intervention on change in body mass index vs. usual care. In an exploratory subgroup analysis, we compared change in body mass index between treatment arms stratified by whether patients had >0.5% reduction in hemoglobin A1c at 12 months. Results Baseline body mass index was 33.5 kg/m2. At 12 months, there was no significant difference in change in body mass index between treatment arms (estimate=−0.02, 95% CI −0.51 to 5.05; P = 0.94); body mass index increased by approximately 0.20 points in both groups. There was also no significant difference in change in body mass index between treatment arms by whether or not patients had >0.5% reduction in hemoglobin A1c (estimate=−0.14, 95% CI −1.21 to −0.92; P = 0.79). Discussion Improved glycemic control was not associated with improved body mass index in the group medical clinic intervention. Given their positive effects on other outcomes, group medical clinics for patients with type 2 diabetes mellitus may be more beneficial if focus is shifted towards weight loss.

scholarly journals A Feasibility Pilot Trial of a Peer-support Educational Behavioral Intervention to Improve Diabetes Medication Adherence in African Americans

2021 ◽  
Author(s):  
Olayinka Shiyanbola ◽  
Martha Maurer ◽  
Mattigan Mott ◽  
Luke Schwerer ◽  
Nassim Sarkarati ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
African Americans ◽  
Effect Size ◽  
Self Efficacy ◽  
Hemoglobin A1c ◽  
The United States ◽  
Post Intervention ◽  
Phone Calls

Abstract BackgroundAfrican Americans are twice as likely to die from diabetes, compared to other racial and ethnic groups in the United States. Poor adherence to diabetes medications is common among African Americans and contributes to these disproportionally worse outcomes. A pilot study was conducted to determine the feasibility and acceptability of a peer-supported intervention targeting diabetes and medication beliefs, communication, and self-efficacy skills to enhance medication adherence among African Americans with type 2 diabetes. MethodsBased on the extended self-regulatory model and information-motivation-behavioral skills model, this intervention was piloted using a single group pre/post-intervention study design at two sites. Seventeen African Americans who self-reported as adherent to diabetes medicines (ambassadors), were paired with 22 African Americans with self-reported poor medication adherence (buddies). Measures assessed at baseline and one-month post-intervention included glycemic control (hemoglobin A1c), self-reported medication adherence, diabetes beliefs, concerns about diabetes medicines, and diabetes self-efficacy. Wilcoxon signed rank tests assessed for differences in mean scores of outcome variables at baseline compared with 3-months follow-up. Semi-structured 60-minute interviews were conducted with each buddy to explore their acceptability of the intervention. To ensure the rigor of the qualitative data, we focused on analytic criteria such as credibility, confirmability, and transferability.ResultsMost buddies and ambassadors were female and about 56 years old. Feasibility outcomes included recruitment success rates of 73% for buddies and 85% for ambassadors relative to our goals. Retention rate for hemoglobin A1c and medication adherence outcome assessment was 95% for buddies. Both buddies and ambassadors had excellent intervention adherence, with buddies having a mean attendance of 7.76 out of 8 sessions/phone calls and ambassadors completing > 99% of the 105 intervention calls with Buddies. Results showed a signal of change in hemoglobin A1c (effect size = 0.14) and medication adherence (effect size = 0.35) among buddies, reduction in buddies’ negative beliefs about diabetes and an increase in necessity beliefs of diabetes medicines. Summative interviews with buddies showed they valued ambassador’s encouragement of self-management behaviors. ConclusionsResults support conduct of an efficacy trial to address medication adherence for African Americans with type 2 diabetes using a peer-supported tailored intervention.

scholarly journals Ketogenic Diet Is Good for Aging-Related Sarcopenic Obesity

2021 ◽  
Author(s):  
Sergey Suchkov ◽  
Tahereh Seifi Salmi ◽  
Chyi-Huey Bai ◽  
Javad Alizargar ◽  
Jia-Ping Wu
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Weight Loss ◽  
Ketogenic Diet ◽  
Ketone Bodies ◽  
Sarcopenic Obesity ◽  
Elderly Age ◽  
Muscle Weight ◽  
Low Carbohydrate

Sarcopenic obesity is a skeletal muscle weight loss disease. It has happened at an elderly age. A ketogenic diet is a low-carbohydrate (5%), moderate protein (15%), and a higher-fat diet (80%) can help sarcopenic obese patients burn their fat more effectively. It has many benefits for muscle and fat weight loss. A ketogenic diet can be especially useful for losing excess body fat without hunger and for improving type 2 diabetes. That is because of only a few carbohydrates in the diet, the liver converts fat into fatty acids and ketones. Ketone bodies can replace higher ATP energy. This diet forces the human body to burn fat. This is a good way to lose fat weight without restriction.

scholarly journals Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review

2021 ◽  
Vol 21 (9) ◽  
Author(s):  
Delphine Tinguely ◽  
Justine Gross ◽  
Christophe Kosinski
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Causal Effect ◽  
Future Research ◽  
Mindful Eating ◽  
Ketogenic Diets ◽  
Time Period ◽  
Short Time

Abstract Purpose of Review To assess the pleiotropic effects of ketogenic diets (KD) on glucose control, changes in medication, and weight loss in individuals with type 2 diabetes, and to evaluate its practical feasibility Recent Findings KD results in improved HbA1c already after 3 weeks, and the effect seems to persist for at least 1 year. This is associated with a reduction in glucose-lowering medications. The weight loss observed after a short time period seems to be maintained with a long-term diet. Adequate support (supportive psychological counseling, enhancing positive affectivity, reinforcing mindful eating) is necessary to achieve a benefit and to assure adherence. Summary Despite the documented decrease in HbA1, a definitive causal effect of KD remains to be proven. KD should be performed under strict medical supervision. Future research should clarify how compliance can be maximized and how ketosis can be optimally monitored.

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